Diagnostic Evaluation of Pediatric Hypertension
The management of hypertension in the pediatric population begins with a thorough diagnostic evaluation which can be tailored to the individual patient based on age, symptoms, and severity of hypertension. We outline four phases of evaluation which are integral to the optimal management of hypertension in children. Phase 1 seeks to determine whether the patient is truly hypertensive in the nonmedical setting. This can be accomplished with either ambulatory blood pressure monitoring or self-monitored (home) blood pressure monitoring. Once hypertension is confirmed, the Phase 2 provides the initial screening for potential etiologies, hypertensive end-organ damage, and comorbidities. Phase 3 of evaluation further defines any abnormality identified during screening, and the Phase 4 determines the significance and remediability of the abnormality. By systematically using the four phases outlined in this chapter, the clinician can conduct a comprehensive yet thoughtful evaluation of the hypertensive patient.
KeywordsSecondary hypertension Diagnosis Evaluation Etiology
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